Clinical Characteristics Of Acute Myocardial Infarction In Patients With Type 2 Diabetes Mellitus

Objective:To analyze the clinical characteristics of acute myocardial infarction in patients with type 2 diabetes mellitus and to investigate the relevant factors of prognosis.Methods:This research retrospectively analyzed 367 patients treated in the department of cardiology of the First Hospital of Shanxi Medical University from the October of 2014 to the September of 2015,who were diagnosed as acute myocardial infarction,including124 cases of acute myocardial infarction combined with type 2 diabetes as Group A, 243 cases of acute myocardial infarction incorporated with type 2 diabetes as Group B.Respectively recorded the baseline data of 367 patients(age, gender, weight, blood pressure, high cholesterol, smoking history), hospitalized admission cases(heart rate, left ventricular end-diastolic dimension and left ventricular ejection fraction), coronary angiography showed coronary artery lesion severity(divided into single, double, three or more) and 6 months follow-up from post-discharge(again angina pectoris and nonfatal myocardial infarction, again reascularization, cardiac death) data. The application of statistical methods organized the data analysis, observed the differences in patients with acute myocardial infarction combined with type 2 diabetes mellitus and patients with acute myocardial infarction incorporated with type 2 diabetes at baseline data, the hospital admission cases, angiography coronary showed lesion degree and the 6 months follow-up from post-discharge, and relevant factors of prognosis.Results:1. The baseline data: including 234 cases of male, 133 cases of female;The maximum is 98 years old, smallest to 33, average age is(61.8±10.9)years old;The average weight is( 68.8 ± 11.7) Kg;Hypertension patient 221 cases, unincorporated hypertension patient 146 cases;36 patients with hyperlipidemia, 331 patients unincorporated with hyperlipidemia.And smoking patients 150 cases, not of 217 patients.Heart rate average is(76.5 ± 35.8)/min.The average of LVDd in patients on admission was(51.7 ± 8.1)mm, the average LVEF was(54.8 ± 14.6)%.According to the results of angiography coronary, involvement of the lesion count of 32 patients with single coronary artery lesions, 52 cases of double branch of coronary lesions, 149 cases of three or three above branches of coronary lesions.35 patients with MACE incident.2. Coronary lesions and MACE happening: First,the degree of coronary artery lesions was evaluated with the involvement of the lesion counts, including 32 cases of patients with single coronary artery pathological changes, 52 patients with double branches of coronary artery disease, 149 patients with more than three and three coronary artery pathological changes;Second, according to the affected parts,left main and multivessel lesions in 68 cases of patients, 48 patients with left main lesion,left anterior descending lesions of 277 cases patients,left circumflex lesion or intermediate branch lesions 226 cases of patients, 245 patients with right coronary lesions;The average number of stent placement was(1.89±1.11).The MACE happened in 35 patients.3. Compared with the Group B,the age and LVEF of patients in Group A was smaller,LVDd was larger,statistically significant difference between the two groups(P<0.05).The gender, history of hypertension, hyperlipidemia, smoking history, body weight,heart rate differences between groups were not significant(P > 0.05).4. Compared with the Group B, the coronary artery lesions in Group A was more serious, with more three brunches of coronary artery lesions, wider lesion site, number of stent placement is more, the differences were statistically significant(P < 0.05).5. Compared with the Group B, the prognosis of patients in Group A was associated with a greater incidence of MACE, statistically significant difference(P < 0.05).6. Factors affecting the MACE:High blood pressure(OR = 2.80 [1.15-6.83]),age(OR = 1.07 [1.03- 1.12]), LVDd(OR = 1.13 [1.06- 1.19]) are risk factors for adverse events,,angiography coronary and successful PCI(OR = 0.23 [0.10- 0.54]) is the protective factor of adverse events.Conclusion:1. Compared with the patients incorporated with type 2 diabetes,AMI patients with type 2 diabetes:A.were attacked at an earlier age,with poorer heart funtion;B.the coronary artery lesions was more serious,the numbers of brunch of coronary artery lesions and lesion site was larger;C.the occurrence of MACE was higher.2. High blood pressure, advanced age, LVDd increasing can increase the risk of MACE occurrence in prognosis of patients with acute myocardial infarction combined with type 2 diabetes,successful PCI can reduce the risk of MACE occurrence.